Bowel Habits after Gastric Bypass Versus the Duodenal Switch Operation

Wasserberg, Nir; Hamoui, Nahid; Petrone, Patrizio; Crookes, Peter F.; Kaufman, Howard S.

doi:10.1007/s11695-008-9658-9

Cited by 22 publications

(11 citation statements)

References 24 publications

(27 reference statements)

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“…Wasserberg et al. [29] reported a faecal incontinence rate of 42.9% (based on self‐reported episodes of faecal incontinence in a 14‐day period), which was significantly higher than the rates reported in other studies postsurgery. In two separate reports, the same authors found a faecal incontinence rate of > 60% in a population of patients seeking bariatric surgery [15,30].…”

Section: Resultsmentioning

confidence: 80%

“…Following surgery, Wasserberg et al. [29] compared the rates of faecal incontinence in patients undergoing RYGB and duodenal switch procedures and found significantly higher rates of incontinence in the RYGB group. Burgio et al.…”

Section: Resultsmentioning

confidence: 99%

“…In the six studies that examined the effects of bariatric surgery on gastrointestinal function, women only were included in two and comprised the majority of subjects in the remaining four ( Table 2) [25][26][27][28][29][30]. While most studies reported baseline data and postsurgery weight-loss outcome, two studies reported postsurgery weightloss outcome only, without baseline data [29,30]. Only one study, Clements et al [26], compared postbariatric surgery patients with controls.…”

Section: Study Design and Patient Populationmentioning

confidence: 99%

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Obesity and bariatric surgery: a systematic review of associations with defecatory dysfunction

et al. 2011

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Few studies have assessed the correlations between obesity and defecatory function and the effect of bariatric surgery. Studies were often not well controlled and used non-uniform instruments to assess bowel function. Obesity appears to be correlated with higher rates of faecal incontinence and diarrhoea. The effects of bariatric surgery on these conditions are not well defined. Well-controlled studies correlating outcome with physiological pelvic floor function are needed.

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Section: Resultsmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 99%

Section: Study Design and Patient Populationmentioning

confidence: 99%

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Obesity and bariatric surgery: a systematic review of associations with defecatory dysfunction

et al. 2011

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“…Diarrhea is a common symptom after RYGB[6,20,24], and usual after BPD[14,25]. Length of the common channel, i.e ., the amount of absorptive surface, seems to play a role, given the higher frequency of diarrhea in long limb/distal RYGB patients than after short limb/proximal RYGB procedures[26], in BPD compared to RYGB[25], and in BPD patients with shorter common channels[27]. …”

Section: Bowel Habit Changes After Bariatric Surgerymentioning

confidence: 99%

Diarrhea after bariatric procedures: Diagnosis and therapy

Borbély¹,

Osterwalder²,

Kröll³

et al. 2017

WJG

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Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of post-bariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients.

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“…It is of note that morbidly obese patients frequently have fecal incontinence due to a rise in intra-abdominal pressure with compression and stretch of the pelvic floor and of the muscles and nerves around the anal sphincter complex and in the vicinity of the supporting endopelvic fascia [12]. After bariatric surgery, many patients initially experience less fecal incontinence due to substantial weight loss and associated improvements of intra-abdominal mechanics [13, 14]. For obvious reasons, patients may even have a lowered frequency and hardened consistency of defecation in comparison to the situation prior to the operation.…”

Section: Introductionmentioning

confidence: 99%

Semiquantitative Assessment of Bowel Habits and Its Relation with Calcium Metabolism after Gastric Bypass Surgery: A Retrospective Study

et al. 2011

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Background. Calcium malabsorption after bariatric surgery may be harmful to skeletal health and demands for optimal skeletal management. Methods. 103 Patients were evaluated retrospectively at 12 months after surgery. The evaluation included a questionnaire about stool frequency and consistency and laboratory assessments. Results. 103 Patients, 27 males and 76 females, were included in the study. 83 Patients had an alimentary limb of 100 cm and 20 patients one of 150 cm. At 12 months after surgery, 77.7% reported changes of bowel habits, albumin adjusted calcium levels were normal in all but 2 patients, and PTH levels were increased in 35%. Correlations between semiquantified bowel scores (fecal scores) and data from the laboratory demonstrated increasing PTH values along with more frequent and softer/watery stools (RR 30.5, CI 6.2–149.2, P < .001). There was a trend for higher PTH levels in patients with an alimentary limb of 150 cm. Normal PTH levels were more frequently found in case of calcium and vitamin D3 use (RR 14.3, CI 3.6–56.5, P < .001). Conclusion. This study demonstrates interrelationships between semi-quantified fecal scores, PTH levels, and the compliance of taking calcium/vitamin D3 suppletion. However, prospective randomized studies are necessary to show causal relationships.

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Bowel Habits after Gastric Bypass Versus the Duodenal Switch Operation

Abstract: Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.

Cited by 22 publications

References 24 publications

Obesity and bariatric surgery: a systematic review of associations with defecatory dysfunction

Obesity and bariatric surgery: a systematic review of associations with defecatory dysfunction

Diarrhea after bariatric procedures: Diagnosis and therapy

Semiquantitative Assessment of Bowel Habits and Its Relation with Calcium Metabolism after Gastric Bypass Surgery: A Retrospective Study

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